Services
Retinal Vein Occlusion
Specialist diagnosis and treatment of branch and central retinal vein occlusion in Melbourne's northern suburbs — from anti-VEGF injections and laser to long-term monitoring and systemic risk factor management.
Retinal Vein Occlusion in Melbourne's Northern Suburbs
Retinal vein occlusion (RVO) is one of the most common retinal vascular disorders and a significant cause of sudden vision loss in adults. Northern Eye Consultants provides specialist assessment and treatment for retinal vein occlusion from our consulting rooms at Northpark Hospital, Bundoora, serving patients across Melbourne's northern suburbs including Epping, Mill Park, Greensborough, Diamond Creek, Eltham, Thomastown, Preston, Reservoir, and Whittlesea.
Early assessment and treatment are important — macular oedema from retinal vein occlusion can cause rapid and significant central vision loss, and the sooner treatment is initiated, the better the potential for visual recovery.
What is Retinal Vein Occlusion?
The retina — the light-sensitive layer at the back of the eye — is supplied by a single artery and drained by a single central retinal vein. The central vein divides into four branch retinal veins as it spreads across the retinal surface.
Branch retinal vein occlusion (BRVO) occurs when one of these branch veins becomes blocked, typically at an arteriovenous crossing point where a retinal artery compresses the underlying vein. The affected quadrant of the retina develops haemorrhages, oedema, and reduced perfusion. If the resulting macular oedema involves the central retinal area, central vision is reduced.
Central retinal vein occlusion (CRVO) occurs when the main retinal vein is blocked at or near the optic disc. All four quadrants of the retina are affected, producing extensive haemorrhages and potentially severe vision loss. CRVO is associated with a higher risk of complications — including neovascular glaucoma from new blood vessel growth — and generally carries a more guarded prognosis than BRVO.
Symptoms
The hallmark presentation of retinal vein occlusion is sudden, painless reduction of vision in one eye. Depending on the location and extent of the occlusion:
- Central vision loss or distortion — if macular oedema is present, affecting the central retina
- Visual field defect — a dark or blurred area affecting part of the visual field, more prominent in BRVO
- Blurred or hazy vision across the whole visual field — more typical of extensive CRVO
- Floaters — from blood or new vessels in the vitreous, in advanced or ischaemic disease
Risk Factors
Retinal vein occlusion shares many risk factors with cardiovascular disease. Hypertension is present in the majority of patients and is the most important modifiable risk factor. Other associations include diabetes mellitus, elevated cholesterol, glaucoma (particularly CRVO, due to elevated intraocular pressure compressing the central retinal vein at the disc), thrombophilia (clotting disorders such as Factor V Leiden mutation or antiphospholipid syndrome — more relevant in younger patients), and hyperviscosity syndromes (such as polycythaemia or myeloma). A full systemic workup at diagnosis is important to identify treatable risk factors.
Diagnosis
At Northern Eye Consultants, assessment of retinal vein occlusion includes:
- Fundus examination — Dilated examination of the retina to assess the distribution of haemorrhages, disc oedema, and signs of ischaemia.
- Optical Coherence Tomography (OCT) — The key investigation for macular oedema — provides precise, quantitative measurement of retinal thickness and fluid. Guides treatment decisions and monitors response.
- Fluorescein angiography — Intravenous dye imaging to map areas of non-perfusion (ischaemia), leakage, and neovascularisation — particularly important when laser treatment is being considered.
- Systemic workup — Blood pressure measurement, blood tests (fasting glucose, HbA1c, lipids, FBC, clotting screen in younger patients), and coordination with your GP to address risk factors.
Treatment Options
Intravitreal anti-VEGF injections are the first-line treatment for macular oedema complicating both BRVO and CRVO. The vessel blockage triggers production of vascular endothelial growth factor (VEGF), which promotes leakage from retinal vessels and accumulation of fluid in the macula. Anti-VEGF agents — including aflibercept (Eylea) and faricimab (Vabysmo) — block this pathway, reducing macular oedema and improving vision. Treatment is typically initiated with monthly injections, then adjusted based on OCT response. Eylea is listed on the PBS for eligible patients with macular oedema due to RVO, significantly reducing the cost of treatment.
Intravitreal steroid implants (Ozurdex — dexamethasone implant) provide a sustained anti-inflammatory and anti-oedema effect over three to six months. They are particularly useful in patients who have had an inadequate response to anti-VEGF therapy, or in cases where the inflammatory component of the occlusion is prominent. Ozurdex is also advantageous for patients who struggle to attend monthly injections, as it requires less frequent administration.
Retinal laser treatment is used for ischaemic retinal vein occlusion with neovascularisation — the growth of abnormal new blood vessels on the retinal surface or iris. Sectoral laser (for BRVO) or panretinal photocoagulation (for CRVO) reduces the ischaemic drive for new vessel formation, preventing vitreous haemorrhage and neovascular glaucoma.
Monitoring is an appropriate strategy for RVO without significant macular oedema, as some cases — particularly BRVO — resolve spontaneously. Regular OCT and clinical review allow treatment to be initiated promptly if oedema develops.
Prognosis
Visual recovery after retinal vein occlusion is variable. BRVO has a generally better prognosis than CRVO. Non-ischaemic occlusions — where retinal perfusion is relatively preserved — respond better to treatment than ischaemic ones, in which extensive loss of retinal blood supply has caused irreversible damage. With modern anti-VEGF therapy, many patients achieve meaningful visual improvement when treatment is initiated promptly. The key predictors of outcome are the extent of initial ischaemia, the degree of macular damage before treatment begins, and the quality of treatment response over time.
Systemic Management — Working with Your GP
Ocular treatment alone is not sufficient — addressing the cardiovascular risk factors that caused the occlusion is essential to prevent a second event and to promote ocular recovery. Good blood pressure control is the single most important systemic intervention. Diabetes management, lipid-lowering therapy, and lifestyle measures (exercise, weight reduction, smoking cessation) are also important.
After each consultation, a detailed report is sent to your referring GP and any involved physicians to support coordinated systemic management. For an overview of other retinal conditions treated at Northern Eye Consultants, see our Medical Retina page. We also provide specialist care for age-related macular degeneration and diabetic retinopathy.
Sudden vision loss? Seek urgent review.
Sudden, painless loss of vision in one eye requires urgent ophthalmological assessment. Contact our rooms immediately on 03 9466 8822. Early treatment gives the best chance of visual recovery.
Our Doctors That Treat Retinal Vein Occlusion
All of our ophthalmologists assess and manage retinal vein occlusion. Dr Xavier Fagan, Dr Jonathan Goh, and Dr David Sousa additionally provide subspecialty depth in medical and surgical retinal care.
Dr Ross MacIntyre
BA (Chemistry), MD, FRANZCO
Corneal, Cataract & Refractive Surgery
General Ophthalmology
Dr MacIntyre is an internationally trained expert in the area of corneal, cataract and refractive surgery. Dr MacIntyre completed his Bachelor of Arts degree in chemistry with Honours at Colgate University in New York, and his Doctor of Medicine with Honours at New York Medical College. After a transitional internship at Columbia University he completed his registrar training in ophthalmology at Brown University. He subsequently undertook subspecialty fellowship training in cornea, complex cataract, and refractive surgery at the Wilmer Eye Institute at Johns Hopkins in Baltimore. He pursued further training as a cornea fellow at the Royal Victorian Eye and Ear Hospital in Melbourne. During his training he has published articles in the medical literature and presented at both international and local scientific meetings. He is a diplomat of the American Board of Ophthalmology, a member of the Alpha Omega Alpha Honour Medical Society in the United States, and a fellow of the Royal Australian and New Zealand College of Ophthalmologists. Dr MacIntyre is a staff specialist at the Royal Victorian Eye and Ear Hospital, where he trains registrars and fellows, and provides public health care. He specialises in medical disease of the cornea and corneal transplant surgery.
Qualifications
- —BA (Chemistry)
- —MD
- —Diplomate American Board of Ophthalmology
- —FRANZCO
Fellowships
- —Wilmer Eye Institute, Johns Hopkins University
- —Royal Victorian Eye and Ear Hospital
Professional Memberships
- —Royal Australian and New Zealand College of Ophthalmologists (RANZCO)
- —American Academy of Ophthalmology
- —American Society of Cataract and Refractive Surgery
- —European Society of Cataract and Refractive Surgery
- —Cornea and Contact Lens Society of Australia
- —Alpha Omega Alpha Medical Honour Society (AOA)
Public Appointments
- —Staff Specialist, Royal Victorian Eye and Ear Hospital
Dr Xavier Fagan
MBBS FRANZCO
Medical Retina & Ocular Inflammatory Disorders
General Ophthalmology
Dr Fagan is a Melbourne based ophthalmologist. He completed his undergraduate medical degree with honours at The University of Melbourne in 2004. Resident medical years were spent at St. Vincent's Hospital Melbourne and The Royal Melbourne Hospital. Dr Fagan commenced his ophthalmology registrar training at the Royal Victorian Eye and Ear Hospital in 2007 and finished in 2011. This provided comprehensive medical and surgical ophthalmology training. He achieved success in the final examinations by receiving the K G Howsam medal for best performing doctor in Australia and New Zealand. He subsequently undertook 18 months of fellowship training in medical retina and ocular inflammatory disorders at the same institution. As part of this fellowship he has published articles in the medical literature and presented at international and local scientific meetings. As a consultant ophthalmologist, Dr Fagan has a public hospital appointment at the Royal Victorian Eye and Ear Hospital. This involves providing public health care and he is actively involved in training of future colleagues. He has an appointment as a clinical lecturer with The University of Melbourne in the faculty of Medicine, Dentistry and Health Sciences.
Qualifications
- —MBBS (Hons)
- —FRANZCO
Awards
- —K G Howsam Medal — Best Performing Ophthalmology Candidate in Australia and New Zealand
Academic
- —Clinical Lecturer, University of Melbourne
Public Appointments
- —Royal Victorian Eye and Ear Hospital
Dr Bernardo Soares
MBBS FRANZCO
Medical & Surgical Glaucoma
General Ophthalmology
Dr Bernardo Soares is an experienced Melbourne Eye Surgeon who specialises in Cataract and Glaucoma Surgeries. Holding public positions at the Glaucoma Unit at the Royal Victorian Eye and Ear Hospital and at Monash Health. He is passionate about complex glaucoma and cataract surgery, ophthalmic teaching and surgical training of future colleagues as well as glaucoma collaborative care. Dr Soares has numerous publications in peer-reviewed journals and constantly presents his work at local and international conferences. He is a Fellow of the Royal Australian and New Zealand College of Ophthalmology, The International Council of Ophthalmology and the Brazilian Council of Ophthalmology.
Qualifications
- —MBBS
- —FRANZCO
- —Fellow, International Council of Ophthalmology
- —Fellow, Brazilian Council of Ophthalmology
Public Appointments
- —Glaucoma Unit, Royal Victorian Eye and Ear Hospital
- —Monash Health
Dr Jonathan Goh
MBBS FRANZCO
Medical Retina
General Ophthalmology
Dr Jonathan Goh is a fellowship trained comprehensive ophthalmologist who sub-specialises in the management of medical retina diseases (diabetic retinopathy, age-related macular degeneration, retinal vein occlusions) whilst also managing general ophthalmic conditions (cataracts, pterygia, chalazia and glaucoma). Dr Goh obtained his medical degree (MBBS, BMedSci), Postgraduate Diploma of Surgical Anatomy (PGDipSurgAnat) and Masters of Surgery (MS) from the University of Melbourne. His Masters of Surgery was awarded for his research in age-related macular degeneration (AMD). He completed his ophthalmology training at the Royal Victorian Eye and Ear Hospital with further subspecialty training in medical retina diseases. Dr Goh has published and presented his findings nationally and internationally in age-related macular degeneration, diabetic retinopathy, and dry-eye disease. Publicly, he works as a consultant ophthalmologist at the Royal Victorian Eye and Ear Hospital, Austin Hospital and Western Health. Dr Goh has a passion for teaching and is actively involved in teaching junior medical staff and is currently the registrar Medical Retina term supervisor at The Royal Victorian Eye and Ear Hospital. He has previously held the Registrar of the Court (2020) position for organising the final ophthalmology examinations that trainees undertake before they are granted their ophthalmology fellowship and recognised as medical specialists.
Qualifications
- —MBBS
- —BMedSci
- —PGDipSurgAnat
- —MS (Surgery)
- —FRANZCO
Academic
- —Masters of Surgery awarded for research in age-related macular degeneration
- —Medical Retina Supervisor, Royal Victorian Eye and Ear Hospital
Public Appointments
- —Royal Victorian Eye and Ear Hospital
- —Austin Hospital
- —Western Health
Dr David Sousa
MBBS FRANZCO
Vitreoretinal Surgery
Dr David Sousa graduated from the Faculty of Medicine of the University of Lisbon in 2013. He completed his Ophthalmology specialty training in Portugal, followed by Vitreoretinal fellowships in Manchester, United Kingdom and Melbourne, Australia. Dr Sousa currently works as a Vitreoretinal Surgeon in Melbourne at The Royal Victorian Eye and Ear Hospital, and in Geelong at the University Hospital and St John of God Hospital. Dr Sousa specialises in the treatment of vitreoretinal conditions including diabetic retinopathy, age-related macular degeneration, retinal detachment, epiretinal membrane, macular hole, and complex lens surgery. Dr Sousa obtained his PhD in 2021 and is currently involved in multiple research projects at Centre for Eye Research Australia, including retinal imaging biomarkers, artificial intelligence, neuroprotection and development of novel surgical devices.
Qualifications
- —MBBS
- —FRANZCO
- —PhD (Centre for Eye Research Australia)
Research
- —Multiple peer-reviewed publications in retinal imaging, artificial intelligence and neuroprotection
- —Regular speaker at international conferences
Public Appointments
- —Royal Victorian Eye and Ear Hospital
- —University Hospital Geelong
Dr Rogan Fraser
FRANZCO
Neuro-Ophthalmology
General Ophthalmology
Dr Rogan Fraser practices comprehensive, general ophthalmology with an interest in neuro-ophthalmology. He graduated from the University of Melbourne with a Doctor of Medicine in 2015 where he was on the Dean's Honours list. Prior to that, he practised as an optometrist in regional Victoria for a number of years, which is where his passion for personalised compassionate and full scope eyecare was developed and honed. Dr Fraser undertook his ophthalmology training through the Royal Victorian Eye and Ear Hospital, and in his final year was appointed the Chief Registrar. He currently works as a consultant in the Neuro-ophthalmology unit at the Eye and Ear, as well as in that hospital's emergency department. In this capacity he supervises and teaches both ophthalmology and neurology trainees. He is a visiting lecturer for Monash and Deakin universities, and has been a faculty member of surgical, and neuro-ophthalmology conferences throughout Australia. He is a Fellow of the Royal Australian and New Zealand College of Ophthalmologists, and a member of both the Neuro-Ophthalmology Society of Australia, and the UK Neuro-Ophthalmology Society.
Qualifications
- —FRANZCO
Academic
- —Visiting Lecturer, Monash University
- —Visiting Lecturer, Deakin University
Professional Memberships
- —Neuro-Ophthalmology Society of Australia
- —UK Neuro-Ophthalmology Society
Public Appointments
- —Neuro-ophthalmology Unit, Royal Victorian Eye and Ear Hospital
- —Emergency Department, Royal Victorian Eye and Ear Hospital
Frequently Asked Questions
What causes retinal vein occlusion?
Retinal vein occlusion occurs when a retinal vein is blocked by a thrombus (blood clot), causing a build-up of pressure that forces blood and fluid to leak into the surrounding retina and macula. The underlying cause is closely linked to cardiovascular risk factors: high blood pressure is the most common association, present in a majority of patients. Other risk factors include diabetes, elevated cholesterol, glaucoma (which increases the likelihood of central retinal vein occlusion by compressing the vein at the optic disc), thrombophilia (blood clotting disorders), and hyperviscosity syndromes. A thorough systemic workup at the time of diagnosis is important to identify and treat modifiable risk factors.
Can vision recover after retinal vein occlusion?
Yes, in many cases. The degree of visual recovery depends on the severity of the occlusion, whether the macula was directly affected by oedema or ischaemia, and how promptly treatment was initiated. Branch retinal vein occlusion (BRVO) generally has a better prognosis than central retinal vein occlusion (CRVO), and non-ischaemic occlusions recover better than ischaemic ones. Anti-VEGF injections can substantially reduce macular oedema and improve vision, particularly when treatment is started early. Some patients recover vision close to their pre-occlusion level; others are left with residual visual impairment. Regular monitoring and prompt treatment give the best possible outcome.
How many injections are needed for retinal vein occlusion?
The number of injections varies considerably between patients. Most patients require an initial loading phase of three monthly injections, after which the response is reassessed on OCT. Some patients achieve lasting resolution of macular oedema and require relatively few further injections. Others have recurrent or persistent oedema and need ongoing treatment over months or years. Steroid implants (such as Ozurdex) are an alternative for selected patients and can reduce the frequency of clinic visits. Your specialist will tailor the treatment schedule to your individual response and monitor you closely at each visit.
Is retinal vein occlusion treatment covered by Medicare?
Yes. Specialist consultations, OCT imaging, retinal photography, and fluorescein angiography are all Medicare-rebateable. Anti-VEGF medications used for macular oedema secondary to retinal vein occlusion — including aflibercept (Eylea) and faricimab (Vabysmo) — are available through the Pharmaceutical Benefits Scheme (PBS) for eligible patients, significantly reducing the out-of-pocket cost of these medications. Retinal laser treatment is also a Medicare-listed procedure. Our team can provide an estimate of any out-of-pocket costs at the time of your referral.
Can retinal vein occlusion happen again?
Yes. People who have had a retinal vein occlusion are at elevated risk of a second event — either in the same eye (for example, a branch occlusion in a different vessel) or in the fellow eye. The risk is highest when the underlying cardiovascular risk factors — particularly high blood pressure, diabetes, and elevated cholesterol — are not well controlled. This is why systemic management is such an important part of overall care after retinal vein occlusion. Working with your GP to optimise blood pressure control, manage lipids, and address diabetes substantially reduces the risk of recurrence.
Concerned About Your Retinal Health?
Contact Northern Eye Consultants to arrange a retinal assessment. A referral from your GP or optometrist is required to access Medicare rebates. Referrals can be sent via HealthLink EDI nthneyec or by calling (03) 9466 8822.